Provider Demographics
NPI:1710796479
Name:NORTH PORT COUNSELING CENTER LLC
Entity type:Organization
Organization Name:NORTH PORT COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:KALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:941-564-9094
Mailing Address - Street 1:12457 TAMIAMI TRL S UNIT 3
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-1455
Mailing Address - Country:US
Mailing Address - Phone:941-564-9094
Mailing Address - Fax:
Practice Address - Street 1:12457 TAMIAMI TRL S UNIT 3
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-1455
Practice Address - Country:US
Practice Address - Phone:941-564-9094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty